Optic neuritis: a 5-year follow-up study of Chinese patients based on aquaporin-4 antibody status and ages.

Abstract

Little work has been performed on the long-term outcome of optic neuritis (ON) according to the status of aquaporin-4 antibody (AQP4-Ab) and long-term prognosis in older patients in China. This study retrospectively analyzed medical records in a cohort of Chinese patients with 5-year follow-up according to AQP4-Ab status and ages from January 2009 to December 2010. The clinical features, laboratory findings and risk factors for prognosis were analyzed. A total of 128 ON patients were included, 66.4% of whom were female. The median age at onset was 36.8years (range 18-73). Serum AQP4-Ab was positive in 45 (35.2%) patients, with greater frequency in the female, bilateral, and recurrent ON groups (48.2, 42.5 and 53.6%, respectively). Seropositive AQP4-Ab ON patients had worse visual recovery compared to seronegative patients (p=0.033). The average and four quadrants of retinal nerve fiber layer (RNFL) thickness were significantly thinner in the seropositive group than in the seronegative group (p<0.05). At 5-year follow-up, the ON recurrence rate was higher in the seropositive AQP4-Ab patients (37/45, 82.3%) than in the seronegative patients (35/83, 42.2%, p<0.001). Among the seropositive patients, 40% (18/45) developed neuromyelitis optica (NMO). Only 1.2% (1/83) of the seronegative patients developed NMO and 4.8% (4/83) developed to MS. Further, the multivariate analysis in seropositive AQP4-Ab patients showed that two risk factors for transverse myelitis (TM) episode were ocular pain and recurrence within 1year. The older patients had worse visual outcome after the first episode of ON than the younger patients (p=0.007). However, the two groups did not differ significantly with regard to prevalence of AQP4-Ab, long-term visual recovery and the risk of developing to NMO/MS.